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Published on: September 5, 2017
Pancreatic tuberculosis
G Brusko1, W S Melvin, J J Fromkes
1Ohio Digestive Disease Institute, Grant Medical Center, Columbus, USA.
The American Surgeon
|June 1, 1995
Summary
Pancreatic tuberculosis is rare, especially in non-endemic areas. This case highlights isolated pancreatic Mycobacterium tuberculosis infection in a healthy patient, successfully treated with triple drug therapy.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Pancreatic tuberculosis is an exceptionally rare condition, typically linked to disseminated miliary tuberculosis or immunocompromised individuals.
- It is seldom encountered in non-endemic geographical regions, making isolated cases noteworthy.
- The presentation can be atypical, complicating early diagnosis.
Observation:
- A healthy North American individual presented with recurrent hyperamylasemia and fevers, symptoms initially suggestive of other pancreatic pathologies.
- Computed tomography (CT) imaging identified a complex, multiloculated lesion in the pancreatic head.
- Intraoperative biopsies revealed granulomatous inflammation, a key histological finding.
Findings:
- Microbiological cultures confirmed the presence of Mycobacterium tuberculosis, establishing the diagnosis of isolated pancreatic tuberculosis.
- The patient received standard triple drug therapy for tuberculosis.
- Post-treatment follow-up CT scans showed complete resolution of the pancreatic lesion.
Implications:
- This case underscores that isolated pancreatic tuberculosis can occur in immunocompetent individuals even in non-endemic regions.
- Early diagnosis through a combination of imaging, biopsy, and microbiological confirmation is crucial.
- Effective treatment with standard antitubercular drugs leads to favorable outcomes and complete recovery.
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